At DCCT baseline, UroEDIC women (n=550) were similar to the remainder (n=130) of the original DCCT women, with the exception that the UroEDIC women had a lower triglyceride level (83.7 vs. 74.9 mg/dl, p=0.04), lower HbA1c (9.6 vs. 9.1%, p=0.003), and were less likely to smoke (25.4% vs. 15.3%, p=0.006). At year 10, there were no significant differences in participant characteristics (i.e. sociodemographic, diabetes-related, health measures) between the 550 UroEDIC women who completed the self-reported questionnaire on incontinence and the 102 women who did not participate in UroEDIC. The mean age for women in UroEDIC was 44±7 years.
Seventeen percent of UroEDIC women reported clinically significant (weekly or more frequent) urinary incontinence during the past year, with daily incontinence reported by 4%, weekly incontinence by 13%, and monthly incontinence by 21%. () When asked about urinary incontinence during the past 7 days, 22.5% (n=124) overall reported any urinary incontinence with 21.6% (n=116) reporting stress incontinence and 10.4% (n=49) reporting urge incontinence. ()
Urinary incontinence in the past 12 months among women with type 1 diabetes in the UroEDIC cohort (N=550)
presents factors potentially associated with incontinence among women in the UroEDIC cohort. In this unadjusted analysis, age, diabetes duration, hemoglobin A1c, body mass index (BMI), change in BMI from DCCT baseline, current smoking, waist circumference, postmenopausal, prior hysterectomy, retinopathy, nephropathy, coronary calcification, hypertension, and urinary tract infections were associated with overall weekly incontinence or one type of incontinence at p<0.2.
Univariate risk factors of weekly urinary incontinence (UI), overall and by type among UroEDIC women at EDIC Year 10, 2002−2004 (N=550)
In the multivariable logistic models, higher body mass index (BMI) was significantly associated with weekly incontinence, both overall and by type. () For each unit (per kg/m2) increase in BMI, incontinence risk increased about 10%. We did not include waist circumference in the multivariable logistic models because of its high correlation with BMI. In exploratory analyses, we found that change in BMI from DCCT baseline also independently predicted weekly incontinence as well as weekly stress incontinence, but was not significantly associated with weekly urge incontinence; these models did not control for year 10 BMI. The mean change in BMI from DCCT baseline for subjects without weekly incontinence both overall and by type was 4.1±4.0.
Risk factors associated with weekly incontinence among UroEDIC women with type 1 diabetes in UroEDIC at Year 10, 2002−2004
Report of two or more UTIs in the prior year was associated with a 5-fold increased risk of weekly urge incontinence. (p=0.01). Urge incontinence was also associated with advancing age (risk increased 42% per 5 years, p=0.03) and there was evidence of less risk among women with very mild retinopathy. There was weaker evidence for increased risk with age for overall weekly incontinence (22% per 5 years, p=0.06).
Of note, we did not find evidence that DCCT cohort stratum or treatment assignment was associated with weekly incontinence, overall or by type, in either unadjusted or adjusted comparisons.